In a recent clinical trial, nearly half of individuals with type 2 diabetes achieved remission to a non-diabetic state after a weight-loss program delivered within 6 years of diagnosis. According to a recently published study, this remission is due to an improvement in the functioning of pancreatic beta cells. These findings, published in Cell Metabolism, are significant as loss of beta-cell function was previously thought to be irreversible in patients with type 2 diabetes.
To follow up on the United-Kingdom-based Diabetes Remission Clinical Trial (DiRECT) trial, which found that recovery from a diabetic state is possible with weight management, the researchers examined metabolic factors including liver fat content, pancreatic fat content, blood concentration of triglycerides, and beta cell function in a subset of participants. They found that those that responded to the weight loss program were similar to non-responders before the intervention but had had diabetes for less time (2.7 years vs 3.8 years). Both responders and non-responders had lost comparable amounts of weight and had similar reductions in liver fat content, pancreatic fat content, and blood concentrations of triglycerides.
However, responders showed early and sustained improvement in beta-cell function. This was particularly pronounced in first-phase insulin response. First phase insulin response is the first of two phases of insulin release in response to blood glucose concentration and entails a brief spike that lasts approximately 10 minutes and is typically absent in type 2 diabetes patients.
These results indicate that starting a weight loss program sooner after diagnosis gives the best chances for pancreatic cell recovery in type 2 diabetes. While more studies are needed to further expand and confirm the results, this could be valuable information in creating treatment programs for type 2 diabetes.
Image: This figure shows cross sectional MRI images are displayed with pixels colour-coded for fat content. In this individual, the high liver fat at baseline (30.4 percent) decreased to 1.3 percent after weight loss. The lower panels, at the level of the pancreas (outlined in white), show the decrease in pancreas fat (8.9 to 7.5 percent) associated with the restoration of first phase and maximal insulin secretion. Image courtesy of Taylor et al.